Although economic evaluation in health care has a long-standing tradition in the United Kingdom, very little is known about its impact on decision making, particularly following the introduction of the internal market. Since managed competition appears to be growing in popularity worldwide, the...

The expansion of community residential facilities for people with a mental handicap requires a significant amount of investment of society’s scarce resources. If the resources are to be used efficiently it is essential that an evaluation of the relative costs and effects of alternative methods...

We review and evaluate the international literature on activity-based funding of health services, focussing especially on experience in Australia (Victoria), Denmark, Norway and Sweden. In evaluating this literature we summarise the differences and pros and cons of three different funding...

This paper illustrates some of the ways in which the Family Practitioner Committee will have to change in order to being about their transformation from the ‘passive paying agency’ into the ‘active manager of customer interests’ when the proposals from the recent White Paper, ‘Working...

International evidence suggests that there are substantial socio-economic inequalities in the delivery of specialist health services, even in the UK and other high-income countries with publicly funded health systems (Goddard and Smith 2001, Dixon et al. 2003, Van Doorslaer, Koolman and Jones...

Every year the United Kingdom central government assesses the relative spending needs of English local authorities in respect of the services for which is it responsible. This is done by estimating a Standard Spending Assessment (SSA) for each service, which is intended to indicate the spending...

Since 2003, 25% of UK general practitioners’ income has been determined by the quality of their care. The 65 clinical quality indicators in this scheme (the Quality and Outcomes Framework) are in the form of ratios, with financial reward increasing linearly with the ratio between a lower and...

Children who come into care of Local Authorities are likely to have significantly poorer health statuses than other children. Foster carers play an increasingly important role as substitute families for such children, a valuable but scarce resource that is costly to recruit and retain. Despite...

The provision of health and social care for people with HIV infection or AIDS and for initiatives aimed at the prevention of the spread of HIV infection has since 1988-89 relied heavily on ring fenced Central Government funding. In 1990/91 the total earmarked central funds available for English...

This Discussion Paper argues that the government has been right both in its rejection of market solutions to health insurance and in its injection of competition into provider markets. The particular advantages of the latter are that the collective expression of demand is maintained, with...